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609 S Long Beach Blvd Compton CA 90221-4026 | |
| (310) 638-1122 | |
| (310) 638-7565 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 609 S Long Beach Blvd, Compton, California |
| Authorized Official Name and Position | Ebenezer Bush (OWNER) |
| Authorized Official Contact | 3106381122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
609 S Long Beach Blvd Compton CA 90221-4026 Ph: (310) 638-1122 | 609 S Long Beach Blvd Compton CA 90221-4026 Ph: (310) 638-1122 |
| NPI Number | 1780839639 |
|---|---|
| Provider Enumeration Date | 11/19/2008 |
| Last Update Date | 11/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780839639 | NPI | - | NPPES |
| B1235501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 12355 (California) | Primary |
Korouri Sage Bina Professional Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 S Long Beach Blvd, Compton, CA 90221 Phone: 310-876-2534 | |
Linda C. Onyeador, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 W Compton Blvd, Suite #103, Compton, CA 90220 Phone: 310-762-9292 Fax: 310-762-6680 |